多层螺旋CT三期增强扫描对小肝癌的诊断价值

Triphasic spiral CT diagnosis of small hepatocellular carcinoma

目的:探讨小肝癌的多层螺旋CT动脉期、门静脉期及延迟期增强表现特征及其诊断价值,进一步提高小细胞肝癌的诊断能力。方法:对30例小肝癌行螺旋CT动脉晚期、门静脉期和延迟期增强扫描,分别于造影剂注射后25～30s、60～70s、3～5min开始扫描,碘海醇注射速率为2.5～3.0ml/s,用量80～100ml。结果:30例小肝癌共发现35个结节病灶。平扫、动脉期、门静脉期及延迟期的检出率分别为65.7%(23/35)、91.4%(32/35)、68.5%(24/35)、88.5%(31/35)。82%(29/35)的小肝癌动脉期呈高密度,静脉期68.5%(24/35)呈低密度,延迟期80%(28/35)呈低密度。动脉期和延迟期敏感性高于门静脉期。三期增强联合检出率为91.4%。结论:多层螺旋CT三期增强扫描可充分反映小肝癌的强化特征,对小肝癌的检出和定性准确率的提高有重要价值。

Objective To investigate the enhanced performance characteristics of multi-slice spiral CT of arterial phase,portal venous phase and delayed phase in small hepatocellular carcinoma and its diagnostic value,and improve the diagnostic ability further.Method Total 30 patients with small hepatocellular carcinoma underwent spiral CT enhanced scan in arterial phase,portal venous phase and delayed phase,began to scan 25~30 s,60~70 s,3~5 min after contrast agent injection,respectively.Iohexol injection was 2.5~3.0 ml/s,the amount was 80~100 ml.Results For 30 cases of small liver cancer,35 nodule lesions were found.The detection rate of unenhanced,arterial phase,portal venous phase and delayed phase were 65.7%（23/35）,91.4%（32/35）,68.5%（24/35）,88.5%（31/35）,respectively.For 82%（29/35）of small liver cancer was high-density in arterial phase,68.5%（24/35）showed a low density in venous phase,80%（28/35）showed a low density in the delayed phase.The sensitivity in arterial phase and delayed phase were higher than portal venous phase.Three-stage combination detection rate was 91.4%.Conclusion Phase enhanced multi-slice CT scan can fully reflect the characteristics of small hepatocellular carcinoma,and has the significant value in detection and qualitative accuracy improvement of small hepatocellular carcinoma.